Guide to Leading a Patient with Symptoms of an Acute Respiratory Infection during a Coronavirus Pandemic (COVID-19)

BACKGROUND: Over 500 viruses and bacteria primarily cause respiratory infections. During COVID-19 pandemic, these respiratory infections remain; i.e., COVID-19 has no ability to suppress these infections from the circulation. Therefore, it is very important to differentiate respiratory infections from COVID-19. Proving the presence of COVID-19 with polymerase chain reaction (PCR) is not evidence that the disease was caused by this virus. Possible options are: First, a random encounter of the virus in the patient’s upper respiratory tract; second, further possible colonization with a coronavirus (or with COVID-19); the third option is to have an infection; and the fourth possibility is to have a disease or COVID-19 upper respiratory infection. Unfortunately, the method with PCR, although it is with high sensitivity and specificity, does not help us to distinguish which of these four possibilities are in question. AIM: We aimed to present a guide to leading a patient with symptoms of an acute respiratory infection during a coronavirus pandemic (COVID-19). RESULTS: A pandemic of COVID-19 shows that many patients get primary viral pneumonia, but people with normal immune system have no problem recovering. People with reduced immunity die from COVID-19, as opposed to the pandemic influenza virus. It is indirectly concluded that COVID-19 in itself is not very virulent, but it weakens the immunity of those infected who already have some condition and impaired immunity. The available scientific papers show that there is no strong cytokine response, patients have leukopenia and lymphopenia, some patients have a decrease in CD4 T-lymphocytes. From the results of the autopsies available so far, it is clear that there are very few inflammatory cells in the lungs and a lot of fluid domination. Hence, SARS-Cov-2 only somehow speeds up the decline in immunity. The previously published radiographic findings of COVID-19 patients, gave a characteristic findings of the presence of multifocal nodules, described as milky glass, very often localized in the periphery of the lung. Whether it is typical pneumonia, atypical, viral, mixed-type pneumonia, or mycotic pneumonia, it can progress to severe pneumonia. The pneumonia becomes severe when breathing is over 30/min; diastolic pressure below 60 mmHg; low partial oxygen pressure in the blood (PaO2/FiO2 <250 mmHg) (1 mmHg = 0.133 kPa); massive pneumonia, bilateral or multilayered lung X-ray; desorientation; leukopenia; and increased urea. CONCLUSION: Patients with COVID-19 placed in intensive care units should be led by a team of anesthesiologists with an infectious disease specialist or an anesthesiologist with a pulmonologist. Critical respiratory parameters should be peripheral oxygen saturation <90%, PaO2/FiO2 ratio 100 or <100, tachycardia above 110/min. &nbsp

KOVID -19 pandemija opasna bolest, panicna reakcija ili rat

Dvo dnevna video konferencija vo organizacija na INstitutot za standardizacija na Srbija, na koj aucestvuvaa golem broj eksperti od regionov, no i od Anglija, Kanada, Svajcarija..

Ваков скок на заболени со Ковид 19 досега не е видено во ниедна држава во светот

Intervju vo portalot LOkalno.MK za trendot na dvizenje na zaboleni so KOVID-1

Практикување на медицина и стоматологија базирана на докази

Медицина/стоматологија базирана на докази претставува совесно, експлицитно и одговорно користење на моментално најдобриот доказ што ќе помогне да се донесе одредена одлука при лекувањето и грижата за индивидуален пациент (Sackett DL,BJM,1996). Доказите се делат на внатрешни и надворешни. Внатрешните докази се темелат на знаењето на лекарот/стоматологот стекнато при неговото образование и континуирано усовршување, како и на искуството од секојдневната практика. Надворешните докази се информации добиени од литературата – во прв ред примарната литература. Постојат различни видови на надворешни докази во зависност од тоа со која методологија, односно, со кој тип/ дизајн на студија се добиени, а достапни се при користење на се поголемиот број на биомедицинските бази на податоци. Практикување на медицина/стоматологија базирана на докази претставува интегрирање на индивидуалното знаење и клиничкото искуство, со моментално најдобриот доказ според светската литература при индивидуалниот пристап кон пациентот. Корист од ваквото практикување имаат и пациентите и лекарите и целиот здравствен систем. Во трудот ќе бидат презентирани епидемиолошките методи кои се основа во научно-истражувачката работа, можните дизајни на студии и прашањата на кои тие треба да одговорат, како и стратегијата за пребарување на литература при практикување на медицина/стоматологија базирана на докази

Nutritional therapy in the treatment of acute corrosive intoxication in adults

Introduction: Acute intoxications with corrosive substances can cause severe chemical injuries of the upper gastrointestinal tract, most often located in the mouth, pharynx, esophagus, stomach and duodenum. If a patient survives the acute phase of intoxication, regenerative response may result in esophageal and/or gastric stenosis, and increased risk of esophageal and gastric cancer. Such intoxication may be fatal due to perforation or tracheal necrosis. Enteral nutrition is a nutritional method when nutritional substances are administered through specially designed tubing placed through the nose or percutaneously, directly into the GIT. Aim: The aim of this study is to describe the methods of artificial nutrition in patients with acute corrosive intoxications and the importance of nutritional support in the treatment of these intoxications. Discussion: Nutrition in the treatment of acute corrosive intoxications is one of the most important therapeutic processes that largely contribute to faster recovery of the post-corrosive injuries of upper GIT, stabilization of biologic, immunologic and metabolic parameters, and reduction of length of stay in hospital Aim of the treatment of acute corrosive intoxications is to prevent perforation and progressive fibrosis, and esophageal and gastric stenosis. There are different and often conflicting positions, on the conservative treatment of acute corrosive intoxications in adults. Such treatment mainly consists of anti-secretory treatment, antibiotics and intensive hyper-alimentation, aiming to prevent late post-corrosive intoxications. Conclusion: It is considered that nutritional support plays a major role in maintenance of metabolic processes and prevention of severe metabolic complications that could additionally aggravate the condition and impair the treatment. Key words: corrosive poisonings, deglutition, deglutition disorders, nutritional therapy, enteral nutrition, parenteral nutritio

Кои се симптомите на ебола

Настап во живо во вестите на на националната ТВ Канал 5, со водителот Мирјан Мирчевска Јовановиќ, наслов на темата: Кои се симптомите на ебола; датум на објава 10 октомври 2014 година во 18Ч и 22 мин https://youtu.be/NHEELlKQdC

Зоонозите како ризик фактор за професионално заболување на ветеринарите и ветеринарните техничари

Ветреинарната професија e ризична професија. Многу студии укажуваат дека ризикот за професионално заболување е голем за 2,9 пати повисок во однос на лекарите во хуманата медицина (Nienhaus) само малите незгоди кои не бараат отсуство од работа поголемо од 3 дена, ризикот поголем до 9 пати во однос на лекарите. Зоонозите се многу чести заболувања меѓу луѓето На нив мора да се мисли без разлика на моменталната епизоотска и епидемилошка состојба. Зоонозите кои предизвикуваат пневмонии мора да се сватат многу сериозно. Ветеринарните работници мора во секое време на преглед или интервенција да носат заштитна облека

Influenza: Epidemics and Pandemics

Influenza is a viral, pandemic and respiratory disease with high morbidity particular and significant mortality rate amongst humans. WHO has counted that each outbreak of epidemic is costing between 10-60 million dollars to one million citizens and each year there are between 250.000 to 500.000 deaths caused by flu. Eight RNA segments of influenza A and B viruses and seven segments of the C viruses are independently encapsulated by viral nucleoprotein. The heamagglutinin is the most important protein of the influenza virus. All antigenic HA and NA subtypes of influenza A viruses are derived from birds. The pig trachea is the only known tissue that contains receptors for avian and human influenza viruses. Influenza occurs in two forms: pandemic and epidemic. Local symptoms such as pharyngitis, coughing, sneezing, discharge, are result from the direct action of the virus, or destruction of billions of cells of the respiratory epithelium. Systemic signs such as fever, malaise, myalgia, chilliness, headaches, occur because of induced and increased levels of cytokines by the virus. Vaccine is the bes prevention against influenza. Immunity is achieved after two weeks of vaccination

Morbidity and mortality of malignant neoplasms in Macedonia

Introductions: Malignant neoplasms are the second cause of death among the population in Republic of Macedonia with representation of and represent 19.0% in the structure of total deaths. Objective: To analyze the morbidity and mortality of the most common malignant neoplasms in Republic of Macedonia. Material and methods: Were used a data from the Institute of Public Health of the Republic of Macedonia, National institute for statistic of Republic Macedonia. Results and discussions: During analyzed period in 2003-2013, morbidity and mortality showed an upward trend. The lowest rate of mortality has was n 2004 (76.3), and highest in 2010 (164.4) per 100.000 inhabitants. In the distribution by gender, the number of deaths by malignant neoplasms shows an increase in both genders, with highest rate of mortality among males in 2012 (216.7), and among females in 2010 (145.1) per 100.000 inhabitants. Rates of mortality are higher among males. From 3654 deaths from malignant neoplasms in 2013 in Republic of Macedonia, males are represented in 60.1% (2196), and females in 39.9% (1458). In the structure of most common causes of deaths, by individual diagnoses among males, on first place are malignant neoplasms of bronchus and lungs with mortality rate of 66.5 (688 deaths), while the second is a followed by malignant neoplasm of the prostate with mortality rate of 19.6 (203 deaths) and the third place belongs to malignant neoplasm of stomach with mortality rate of 19.1 (198 deaths). Among the female population, the first place belongs to malignant neoplasms of the breast with mortality rate of 26.4 (240 deaths), while the second is followed by malignant neoplasm of bronchus and lungs at a rate of 15.3 (158 deaths). On the third place is malignant neoplasm of the stomach with mortality rate of 10.6 (109 deaths). In distribution by municipalities in 2013, the highest rates of mortality are in Krivogashtani with 21 total of deaths and with mortality rate of 368.4 per 100.000 inhabitants., Demir Hisar with 26 total of deaths or mortality rate of 303.9 per 100.000 inhibitants and Berovo with 34 total of deaths and a mortality rate of 252.9 per 100.000 inhabitants. Conclusion: Malignant neoplasms are the second cause of death among the population of Republic of Macedonia, after the diseases of circulatory system. During period between 2003-2012, the morbidity and mortality showed an upward trend. In the distribution by gender, the number of deaths from malignant neoplasms shows a positive development tendency in both genders. Mortality rates are higher among males. The most common cause of death from malignant neoplasms are malignant neoplasms of bronchus and lungs. The most common cause of death from malignant neoplasms among females, is malignant neoplasm of the breast. Keywords breast, bronchus, lungs, morbidity, mortality, neoplasms, prostate, stomac

Incidence of breast cancer in Macedonia

Introduction: Breast cancer is an abnormal growth and uncontrolled division of cells in the breast. Breast cancer is the most common cancer among women in the country and the most common cause of cancer death in women. According to the WHO, breast cancer is the most common cancer in women worldwide, claiming the lives of hundreds of thousands of women each year. Purpose: The purpose of this work is to determine the incidence of breast cancer in the Republic of Macedonia and setting relation in terms of the prevalence of this disease in the world. Materials and Methods: Within this analysis, data were taken from the hospital in the region of the capital Skopje, which marks the most populated. These data represent the men and women suffering from breast cancer who were hospitalized. The data used were obtained from the Centre for Public Health, National Institute of Statistics - MAKStat base, Institute of Public Health, data taken from the organization Borka and International Agency for research on cancer - EUCAN. Results: In Macedonia, breast cancer is the first of malignant disease in women. According to the Institute of Public Health , the incidence of breast cancer is about 696 / 100,000 cases , while mortality is 240 / 100,000 that is represented by the absolute values of 147 men and 1280 women such cases in 2014, 225 men and 839 such cases in 2013 and 139 men and 2629 women such cases in 2012 . Breast cancer in men is found in about 6 % of cases respectively in 2014 there were 147 infected men. Most patients are from 50-59 years of age. Conclusion: In Macedonia, breast cancer is the first of malignant disease in women. The country is a country with an average incidence rate, but with higher mortality. The number of cases of breast cancer has increased in 2014. Most cases of this disease is 50-59 years. In a small percentage of breast cancer are diagnosed and men with 6%. Keywords breast cancer, disease incidence, Macedonia